- Email: [email protected]
SYSTOLIC BLOOD PRESSURE AND COGNITIVE IMPAIRMENT IN A TANZANIAN POPULATION: IS HYPERTENSION PROTECTIVE AGAINST DEMENTIA IN THE ELDERLY?
P1048
Poster Presentations: Tuesday, July 18, 2017
decreased at follow up, showing a 8% (40 pg/mL) reduction as compared with baseline (p¼0.03).
P3-274
STRUCTURAL CORRELATES OF ALZHEIMER’S DISEASE AND AGING IN DOWN SYNDROME: AN MRI STUDY
Victor Montal1,2, Eduard Vilaplana1,2,3, Maria CarmonaIragui1,2,3,4, Jordi Pegueroles1,2,3, Sofıa Gonzalez-Ortiz5, Bessy Benejam4, Daniel Alcolea1,2,3, Laura Videla4, Susana Fernandez4, Sebastian Videla4, Rafael Blesa1,2,3, Alberto Lle o1,2,3, Juan Fortea1,2,3,4, 1Centre of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain; 2Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; 3Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain; 4Catalan Foundation for Down Syndrome, Barcelona, Spain; 5Parc de Salut, Hospital del Mar, Barcelona, Spain. Contact e-mail: [email protected] Background: Down syndrome (DS) has been proposed as a genetic form of Alzheimer’s Disease (AD). However, few studies had assessed the structural correlates of AD and aging in DS. Our objective was to evaluate the brain regions vulnerable to AD and aging in DS and the possible modulating effects of amyloid deposition. Methods: Subjects were recruited from the Down Alzheimer Barcelona Neuroimaging Initiative (DABNI), a longitudinal cohort to study AD in DS. 68 subjects underwent a 3 Tesla structural MRI and a lumbar puncture (mean age: 41.32, 34.1% female). DS subjects were classified into a cognitive stable group (cs-DS, N¼52) and an AD group (N¼16). The AD group was subdivided into prodomal Alzheimer (p-DS, N¼10) and AD dementia (d-DS, N¼6) subgroups. CSF Aß1-42 levels were measured by ELISA. Subjects were classified as Aß+ or Aß- (cutoff <550pg/ml). Cortical thickness (CTh) and normalized hippocampal volume (HV) were obtained using Freesurfer v5.1. We computed the mean CTh in a well-known AD signature map (Dickerson 2009). We performed group comparissons and correlation analyses. We also performed an interaction analysis between age and CSF Aß1-42 to show the regions with an amyloid by age interaction on CTh. Results: The AD group had extensive regions of cortical atrophy in posterior temporoparietal areas with a relative preservation of frontal areas when compared with s-DS. There was a significant gradient of atrophy in the AD signature and HVacross groups (d-DS>p-DS>cs-DS). Aging negatively correlated CTh in cs-DS in regions of the frontal cortex. This correlation was also significant for HV but not for the AD signature. CSF Aß1-42 did not correlate with CTh and there were no differences in the Aß+ vs Aß- comparison in cs-DS. However, we found a significant interaction between CSF Aß1-42 levels and age on brain structure in posterior regions. Conclusions: Our data suggest that the CTh patterns of aging and dementia aging and dementia differ in DS. Aging might affect predominantly frontal regions, whereas AD af-
fects mainly temporoparietal regions. Amyloid deposition might shift the aging atrophy pattern to posterior regions. Our data suggests that the brain regions vulnerable to AD are the same in DS.
P3-275
SYSTOLIC BLOOD PRESSURE AND COGNITIVE IMPAIRMENT IN A TANZANIAN POPULATION: IS HYPERTENSION PROTECTIVE AGAINST DEMENTIA IN THE ELDERLY?
William K. Gray1, Stella-Maria Paddick2,3, Cecilia Collingwood4, Catherine Dotchin3, Aloyce Kisoli5, Godfrey Mbowe6,7, Sarah Mkenda5, Carolyn Lissu8, Jane Rogathi9, John Kissima10, Richard Walker1,11, 1 Northumbria Healthcare NHS Trust, North Shields, United Kingdom; 2 Newcastle University, Newcastle upon Tyne, United Kingdom; 3 Northumbria Healthcare NHS Foundation Trust, North Shields, United Kingdom; 4Northumbria Healthcare NHS Foundation Trust, North Shelds, United Kingdom; 5Kilimanjaro Christian Medical University College, Moshi, Tanzania; 6Mawenzi Regional Hospital, Moshi, Tanzania; 7 Kilimanjaro Christian Medical College, Moshi, Tanzania; 8Kilimanjaro Christian Medical University College, Moshi, Tanzania; 9Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania; 10Hai District Hospital, Boman’gombe, United Republic of Tanzania; 11Newcastle University, Newcastle Upon Tyne, United Kingdom. Contact e-mail: [email protected] Background: There is some evidence from high-income countries
that highe systolic blood pressure may be protective against cognitive impairment in the elderly. However, there are few data from low-income settings, such as sub-Saharan Africa, where, for the majority of the population hypertension is largely untreated and genetic and lifestyle factors may mediate the relationship. Methods: This study had a cross-sectional design. Study participants were recruited from people who attended screening days held in villages within the rural Hai district of Tanzania; all were over 60 years old. Demographic data were recorded. Blood pressure was measured three times in a sitting position, with an average taken of readings two and three. Cognition was assessed using the IDEA cognitive screen, which was developed for use in low-education communities and has been validated for use in this setting. Results: Data were available for 454 (252 females, 55.4%) of 466 older adults screened. Thirty-nine (8.6%) screened positive for major cognitive impairment and 319 (70.3%) were hypertensive (140/90 mmHg). Higher systolic (but not diastolic) blood pressure was associated with lower odds of screening positive for dementia (OR 0.987 (95% CI 0.975 to 0.999), p ¼ 0.036). The relationship remained after adjusting for the effects of age, sex and education level (OR 0.983 (95% CI 0.970 to 0.997), p ¼ 0.016). Conclusions: Our data support previous reports that higher systolic blood pressure is associated with better cognitive function in the elderly and extends the observation to an East African population. However, further work, with long-term follow-up is needed to establish if any link is causal.
P3-276
BEHAVIORAL VARIANT FRONTOTEMPORAL DEMENTIA AS A SERIOUS COMPLICATION OF SPONTANEOUS INTRACRANIAL HYPOTENSION
Wouter Schievink, Marcel Maya, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Contact e-mail: [email protected]
Poster Presentations: Tuesday, July 18, 2017
decreased at follow up, showing a 8% (40 pg/mL) reduction as compared with baseline (p¼0.03).
P3-274
STRUCTURAL CORRELATES OF ALZHEIMER’S DISEASE AND AGING IN DOWN SYNDROME: AN MRI STUDY
Victor Montal1,2, Eduard Vilaplana1,2,3, Maria CarmonaIragui1,2,3,4, Jordi Pegueroles1,2,3, Sofıa Gonzalez-Ortiz5, Bessy Benejam4, Daniel Alcolea1,2,3, Laura Videla4, Susana Fernandez4, Sebastian Videla4, Rafael Blesa1,2,3, Alberto Lle o1,2,3, Juan Fortea1,2,3,4, 1Centre of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain; 2Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; 3Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain; 4Catalan Foundation for Down Syndrome, Barcelona, Spain; 5Parc de Salut, Hospital del Mar, Barcelona, Spain. Contact e-mail: [email protected] Background: Down syndrome (DS) has been proposed as a genetic form of Alzheimer’s Disease (AD). However, few studies had assessed the structural correlates of AD and aging in DS. Our objective was to evaluate the brain regions vulnerable to AD and aging in DS and the possible modulating effects of amyloid deposition. Methods: Subjects were recruited from the Down Alzheimer Barcelona Neuroimaging Initiative (DABNI), a longitudinal cohort to study AD in DS. 68 subjects underwent a 3 Tesla structural MRI and a lumbar puncture (mean age: 41.32, 34.1% female). DS subjects were classified into a cognitive stable group (cs-DS, N¼52) and an AD group (N¼16). The AD group was subdivided into prodomal Alzheimer (p-DS, N¼10) and AD dementia (d-DS, N¼6) subgroups. CSF Aß1-42 levels were measured by ELISA. Subjects were classified as Aß+ or Aß- (cutoff <550pg/ml). Cortical thickness (CTh) and normalized hippocampal volume (HV) were obtained using Freesurfer v5.1. We computed the mean CTh in a well-known AD signature map (Dickerson 2009). We performed group comparissons and correlation analyses. We also performed an interaction analysis between age and CSF Aß1-42 to show the regions with an amyloid by age interaction on CTh. Results: The AD group had extensive regions of cortical atrophy in posterior temporoparietal areas with a relative preservation of frontal areas when compared with s-DS. There was a significant gradient of atrophy in the AD signature and HVacross groups (d-DS>p-DS>cs-DS). Aging negatively correlated CTh in cs-DS in regions of the frontal cortex. This correlation was also significant for HV but not for the AD signature. CSF Aß1-42 did not correlate with CTh and there were no differences in the Aß+ vs Aß- comparison in cs-DS. However, we found a significant interaction between CSF Aß1-42 levels and age on brain structure in posterior regions. Conclusions: Our data suggest that the CTh patterns of aging and dementia aging and dementia differ in DS. Aging might affect predominantly frontal regions, whereas AD af-
fects mainly temporoparietal regions. Amyloid deposition might shift the aging atrophy pattern to posterior regions. Our data suggests that the brain regions vulnerable to AD are the same in DS.
P3-275
SYSTOLIC BLOOD PRESSURE AND COGNITIVE IMPAIRMENT IN A TANZANIAN POPULATION: IS HYPERTENSION PROTECTIVE AGAINST DEMENTIA IN THE ELDERLY?
William K. Gray1, Stella-Maria Paddick2,3, Cecilia Collingwood4, Catherine Dotchin3, Aloyce Kisoli5, Godfrey Mbowe6,7, Sarah Mkenda5, Carolyn Lissu8, Jane Rogathi9, John Kissima10, Richard Walker1,11, 1 Northumbria Healthcare NHS Trust, North Shields, United Kingdom; 2 Newcastle University, Newcastle upon Tyne, United Kingdom; 3 Northumbria Healthcare NHS Foundation Trust, North Shields, United Kingdom; 4Northumbria Healthcare NHS Foundation Trust, North Shelds, United Kingdom; 5Kilimanjaro Christian Medical University College, Moshi, Tanzania; 6Mawenzi Regional Hospital, Moshi, Tanzania; 7 Kilimanjaro Christian Medical College, Moshi, Tanzania; 8Kilimanjaro Christian Medical University College, Moshi, Tanzania; 9Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania; 10Hai District Hospital, Boman’gombe, United Republic of Tanzania; 11Newcastle University, Newcastle Upon Tyne, United Kingdom. Contact e-mail: [email protected] Background: There is some evidence from high-income countries
that highe systolic blood pressure may be protective against cognitive impairment in the elderly. However, there are few data from low-income settings, such as sub-Saharan Africa, where, for the majority of the population hypertension is largely untreated and genetic and lifestyle factors may mediate the relationship. Methods: This study had a cross-sectional design. Study participants were recruited from people who attended screening days held in villages within the rural Hai district of Tanzania; all were over 60 years old. Demographic data were recorded. Blood pressure was measured three times in a sitting position, with an average taken of readings two and three. Cognition was assessed using the IDEA cognitive screen, which was developed for use in low-education communities and has been validated for use in this setting. Results: Data were available for 454 (252 females, 55.4%) of 466 older adults screened. Thirty-nine (8.6%) screened positive for major cognitive impairment and 319 (70.3%) were hypertensive (140/90 mmHg). Higher systolic (but not diastolic) blood pressure was associated with lower odds of screening positive for dementia (OR 0.987 (95% CI 0.975 to 0.999), p ¼ 0.036). The relationship remained after adjusting for the effects of age, sex and education level (OR 0.983 (95% CI 0.970 to 0.997), p ¼ 0.016). Conclusions: Our data support previous reports that higher systolic blood pressure is associated with better cognitive function in the elderly and extends the observation to an East African population. However, further work, with long-term follow-up is needed to establish if any link is causal.
P3-276
BEHAVIORAL VARIANT FRONTOTEMPORAL DEMENTIA AS A SERIOUS COMPLICATION OF SPONTANEOUS INTRACRANIAL HYPOTENSION
Wouter Schievink, Marcel Maya, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Contact e-mail: [email protected]